Part II: Managing the Psychosocial Needs of a Mesothelioma Patient – the Medical Provider’s Perspective
by Nancy Meredith
For a doctor, management of the issues surrounding a patient’s diagnosis of mesothelioma, or any other incurable cancer, requires careful recordkeeping, meticulous review of tests and constant monitoring of the patient’s health. According to a 2007 breakthrough study conducted by the Institute of Medicine (IOM), physicians should also monitor the social and emotional health, or psychosocial needs, of patients to lessen their suffering and to “support their return to health.”
Patient Stress Can be Crippling
Mesothelioma is a unique and rare form of cancer, typically affecting the lining of the lungs, caused by exposure to asbestos fibers. The cancer is highly aggressive and is resistant to standard cancer treatments making it a difficult disease to treat effectively. Unfortunately, the effectiveness of a mesothelioma patient’s treatment can be adversely affected by the burden of managing the disease, while at the same time trying to maintain normalcy at home.
Numerous studies have been conducted that show that positive thinking can result in the improvement in a patient’s health. On the other hand, if a patient does not receive proper support managing the vast number of issues they are faced with after a terminal cancer diagnosis, such as financial issues, transportation needs, personal care and family management, the stress can lead to depression, anxiety and failing health. The IOM committee stressed that, “Psychosocial issues in cancer are palpable, important, and potentially crippling.”
Six Domains of Psychosocial Needs
In the report entitled Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs the IOM committee found that patients, physicians and other cancer care providers agree that “attention to patients’ psychosocial health needs is the exception rather than the rule in cancer care today.”
To better address the emotional care of the patients, the IOM identified six domains of psychosocial needs for physicians to monitor:
- Understanding of illness, treatments, and services;
- Coping with emotions surrounding illness and treatment;
- Managing illness and health;
- Behavioral change to minimize disease impact;
- Managing disruptions in work, school and family life; and
- Financial Assistance.
The authors of the study also identified various health services that are available for the physician to refer their patients. Services include strategies to improve patient-provider communication, peer support groups, counseling/psychotherapy, behavioral /health promotion interventions such as smoking cessation help, family and caregiver education, financial planning and eligibility assessment for Social Security Disability Income. A number of mesothelioma-specific foundations and charities exist that can meet the unique needs of a mesothelioma sufferer. The Mesothelioma Applied Research Foundation offers advocacy, support and treatment information.
Adoption of Standards
The committee went as far as presenting a standard for healthcare providers to follow that can lead to the improvement of cancer care. The standard sets forth mechanisms “to ensure that appropriate psychosocial health services are provided.” The IOM also recommended that these standards be adopted by the National Cancer Institute, the Centers for Medicare and Medicaid Services, and all other organizations that set standards for cancer care. They encourage these organizations to incorporate psychosocial health into their research topics, policies, protocols and standards.
The IOM concluded their report saying, “All patients with cancer and their families should expect and receive cancer care that ensures the provision of appropriate psychosocial health services.” They went on to point out to the medical profession that, “Today, it is not possible to deliver good-quality cancer care without addressing patients’ psychosocial health needs.”
